VP Quarterly Report on Strategies Q1 – 2015/16 Vision: Healthy people, families and communities. Acting VP: Dawn Calder Integrated Health Services – Clinical Support Multi-year Plan: ED Waits and Patient Flow

Portfolio Overview Patient Flow Pharmacy & Respiratory Services Medical Imaging Lab Services Rehabilitation, Spiritual Care & Native Health Services HealthLine Support Services, Central Scheduling & Sterile Processing

Multi Year Strategic Plan VP leading on: Corporate Patient Flow Multi-year Plan:  Provincial Hoshin ED Waits & Patient Flow Implementation Strategy  RQHR Multi Year Strategic Plan & Business Plan  RQHR Patient Flow Program / Framework

Patient Flow Multi-year Plan 2015/16 Provincial Outcome & Improvement Targets for Patient Flow By March 31, 2017, no patient will wait for care in the emergency department. -(Hoshin) By March 31, 2016, 90% of patients waiting for an inpatient bed will wait <= 17.5 hours. -By March 31, 2016, the length of stay (LOS) in the ER for 90% of admitted patients will be <= 22.3 hours -By March 31, 2016, the LOS in the ER for 90% non- admitted patients will be <= 5.9 hours

Hoshin Measure – Combined

Hoshin Measure - RQHR Time waited in the ED for an inpatient bed: 90th percentile in hours

Patient Flow Multi-year Plan

Status of Strategy Implementation Successes Successes/What is working -Recognized Provincially and Nationally for our Success -Improved occupancy and ANB # -Continued Shift in Culture and Ownership: Flow is “our” issue -Patient Flow Visibility Wall -Corrective Action Plans -Improves understanding of system view and connection -Patient Flow Analytics -Improving access to data -Excellent engagement from operational areas -FloCast -Accountable Care Unit- early results -Improved patient care, participation and awareness of care plan -Staff and physician engagement

RQHR FloCast

RQHR FloCast Accuracy 11

Medicine Program Occupancy 104% Target: 95% Occupancy 14 day trend UnitOccupancy Unit 3E106%  Unit 5E100% ▲ Unit 6F108%  Patient Flow Dashboard > RQHR > RGH > Last Updated: Today at 11:50am 6 month average Past 24 hours Avg. ED Pull Time 7.0 hours Target: < 4.0 hours Transfers from ICU 2 patients Typical: 4 Patients Admitting Pressures 6 month average Medicine Avg. LOS 7.5 days Target: < 6.0 Days Off-Service Beds 29 patients Target: < 6 Patients Inpatient Performance 28 patients admitted over 31 days Target: < 30 Patients Past 24 hours Past Week Net Flow +18 patients Target: < 0 Patients D -1 Accuracy 61% Target: > 70% Discharging Performance 1 discharge before 11:00 Target: > 5 Discharges Past 24 hours 6 month average Inflow Outflow Management Admitting Pressures 10 ANB patients Target: < 5 Patients  12

Unit 3E Program Occupancy 106% Target: 95% Occupancy 14 day trend Last Updated: Today at 11:50am 6 month average Past 24 hours Avg. ED Pull Time 6.3 hours Target: < 4.0 hours Transfers from ICU 1 patient Typical: 4 Patients Admitting Pressures 6 month average Medicine Avg. LOS 7.2 days Target: < 6.0 Days Inpatient Performance 16 patients admitted over 31 days Target: < 30 Patients Past 24 hours Past Week Net Flow +1 patient Target: < 0 Patients D -1 Accuracy 67% Target: > 70% Discharging Performance 0 discharges before 11:00 Target: > 3 Discharges Past 24 hours 6 month average Inflow Outflow Management Admitting Pressures 3 ANB patients Target: < 3 Patients  Patient Flow Dashboard > RQHR > RGH > Medicine > 13

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Status of Strategy Implementation – Challenges & Risks Challenges/Gaps/Risks Significant Work Required to Achieve Targets Consistent Use of Patient Flow Standard Work and Tools Shifting from Reactive to Proactive

Next Steps -Visioning Session -Validation of targets and activities -Incorporation of actions into each areas multi-year plan -Continued coordination of activities -Patient Flow Analytics -Initial unit/system level dashboard functionality ( next 3-4 months) -Patient Flow Standard Work Coaching Support for IP Units. -Continued Implementation of ACU